“Despite new information that the disease burden of schistosomiasis in Africa may be equivalent to malaria or HIV/AIDS and a simple annual anthelminthic treatment for this disease is available for less than 50 cents per person including delivery costs, we now know that fewer than 5% of the infected population is receiving coverage. To date, this situation represents one of the first great failures of the “global health decade” that began in 2000.”

Well said. That is a quote from a new editorial by Peter Hotez and Alan Fenwick in the latest PLoS Neglected Tropical Diseases. A few years ago there was little attention given to any of the neglected tropical diseases, but today, thanks largely to advocacy efforts of the authors of this editorial, financial donations from the Gates Foundation and the US government, and to the efforts of some powerful drug donation partnerships (think Merck and Glaxo for onchocerciasis and lymphatic filariasis respectively) significant progress has been made at increasing coverage of at risk populations throughout the developing world.

As the authors of this editorial argue, schistosomiasis, has not fared as well as some of the other NTDs. There are many reasons for this, so there is no easy answer as to why it is has been disproportionately neglected. Praziquantel the drug used to treat this disease has been around far longer than the drugs used to treat onchocerciasis and lymphatic filarisis. As such, by the time the disease was getting attention at the global level no major drug company was around to champion its cause or put together a drug donation program (is this an example of how patents by drug companies can actually be good for global health?). In fact, the market has been through so many ups and downs over the decades that is not surprising that the availability of the drug is a problem.

In an era of calls for universal access to ARVs and country wide bed net distribution programs, it is hard to believe that we cannot come up with $100 million a year to cover most of those in need of protection from this debilitating disease. But sadly, this is the reality.

For those really interested in this topic, there is a great chapter (chapter 3) on the challenges to access to praziquantel in the Access Book by Frost and Reich, which is available here.

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